Individual
D'ANNA KYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAT, ATC
Contact information
Practice address
1013 GLACIER LN, EDMOND, OK 73003-4664
(417) 684-0178
Mailing address
1013 GLACIER LANE, EDMOND, OK 73003
(417) 684-0178
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT2009010050
MO
2255A2300X
Athletic Trainer
Primary
AT795
OK
Other
Enumeration date
06/07/2016
Last updated
07/22/2016
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